EP0705615A1 - Ventilation apparatus for the treatment of sleep apnoea - Google Patents

Ventilation apparatus for the treatment of sleep apnoea Download PDF

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Publication number
EP0705615A1
EP0705615A1 EP95113816A EP95113816A EP0705615A1 EP 0705615 A1 EP0705615 A1 EP 0705615A1 EP 95113816 A EP95113816 A EP 95113816A EP 95113816 A EP95113816 A EP 95113816A EP 0705615 A1 EP0705615 A1 EP 0705615A1
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EP
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Prior art keywords
patient
pressure
breathing
base value
value
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Granted
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EP95113816A
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German (de)
French (fr)
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EP0705615B1 (en
Inventor
Bernd Graetz
Jörg Maurer
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Loewenstein Medical Technology GmbH and Co KG
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Loewenstein Medical Technology GmbH and Co KG
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Priority to EP03001806A priority Critical patent/EP1306099A3/en
Publication of EP0705615A1 publication Critical patent/EP0705615A1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/085—Measuring impedance of respiratory organs or lung elasticity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M16/0006—Accessories therefor, e.g. sensors, vibrators, negative pressure with means for creating vibrations in patients' airways
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics
    • A61M2230/46—Resistance or compliance of the lungs

Definitions

  • the invention relates to a method for controlling a respirator for therapy of sleep apnea and a device for performing the method.
  • insomnia C ontinuous P A irway P ressure
  • CPAP C ontinuous P A irway P ressure
  • the gas flow is either supplied to the patient at a constant pressure or is reduced to a lower pressure level to make it easier for the patient to exhale when exhaling.
  • the object of the invention is now to make the CPAP therapy patient-friendly.
  • oscillatory pressure amplitude which corresponds to the patient's breathing resistance
  • ORM oscilloresistometry
  • this device is only activated, ie. H. Breathing gas is only supplied to the patient if the breathing activity of the patient is disturbed by an apnea or if the breathing resistance - and thus also the measured oscillatory pressure amplitude - changes as a result of apnea.
  • a disturbance in the patient's breathing activity is accompanied by a change in the patient's breathing resistance. This resistance is easily and reliably determined in a reproducible manner via the changes in the oscillatory pressure amplitude without affecting the patient's condition.
  • the patient's condition can be beneficial Further development of the method according to the invention can be further increased by continuously supplying the patient with breathing gas with a moderate basic pressure of 3 to 5 mbar, increasing the gas pressure in the event of deviations from the individual breathing resistance value (basic value) and lowering it to the basic pressure as soon as the basic value is approximately reached again .
  • This continuous gas supply not only supports the breathing work of the patient, but also has an advantageous effect on the determination of the parameters required to control the pressure of the breathing gas.
  • phase angle is used as additional control and / or regulating signals for the ventilator the pressure amplitude and / or the respiratory flow of the patient are used in order to increase the pressure of the supplied breathing gas in the event of significant deviations from the respective individual base values determined at the beginning of the therapy until the base values are reached again or approximately.
  • a respirator for carrying out the method according to the invention consists of a compressed gas source connected to a breathing mask and expediently designed as a fan and is characterized by a device for the continuous measurement of the oscillatory pressure amplitude of a patient according to the ORM principle and a control and regulating device which relate to the individual base value of the oscillatory pressure amplitude corresponding to the respiratory resistance value of a patient is adjustable and the compressed gas source is activated in such a way that respiratory gas is supplied to the patient if there are significant deviations of the respiratory resistance from the base value.
  • the respirator can also have, as further control elements for activating the compressed gas source, a device for measuring and determining the phase angle of the pressure amplitude and / or a device designed as a pneumotachograph or measuring orifice for determining the patient's respiratory flow.
  • the respirator can also be provided with a pressure regulator for the breathing gas that can be adjusted to the needs of the patient, which increases the acceptance of the therapy device, since the patient is ventilated with a constant pressure that is pleasant for him when the oscillatory pressure amplitude and / or the phase angle of the pressure amplitude and / or the respiratory flow of the patient corresponds to the basic value (s).
  • the respirator for therapy of sleep apnea has a breathing mask 1 which can be arranged on the nose of a patient and which is connected via a breathing tube 8 to a compressed gas source 2 designed as a fan.
  • the sensors (not shown) of a device 3 for continuously measuring the oscillatory pressure amplitude according to the ORM principle are provided in the breathing mask 1.
  • the pressure gas source 2 is activated by a control-regulating device 4, which is connected to the device 3 and can be adjusted to the individual base value of the oscillatory pressure amplitude corresponding to the breathing resistance of the patient, so that breathing gas is supplied to the patient in the event of significant deviations in the pressure amplitude from the base value.
  • a measuring orifice 7 is inserted into the breathing tube 8, which detects the respiratory flow and forwards the corresponding data via a measuring device 6 to the control and regulating device 4 for further influencing the compressed gas source 2.
  • the sensors (not shown) of another device 5 for measuring the phase angle of the pressure amplitude are also provided.
  • the device 5 sends to the control and regulating device 4 signals that serve as additional control parameters when activating pressure source 2.

Abstract

The control uses an oscillatory resistance measurement for continuous monitoring of the oscillatory pressure amplitude of the patient and the corresponding respiration resistance, for controlling the supply of respiration gas under pressure. The monitored respiration resistance is compared with a base respiration resistance value for the patient, with the respiration gas supplied when the measured respiration resistance differs from the base value and is blocked or reduced to a min. value when the measured respiration resistance corresponds to the base value.

Description

Die Erfindung betrifft ein Verfahren zur Steuerung eines Beatmungsgerätes zur Therapie der Schlafapnoe und eine Vorrichtung zur Durchführung des Verfahrens.The invention relates to a method for controlling a respirator for therapy of sleep apnea and a device for performing the method.

Eine nicht unbeachtliche Anzahl von Menschen leiden unter Schlafstörungen, die sich auf das Tagesbefinden dieser Menschen auswirken und deren soziale und berufliche Leistungsfähigkeit sowie deren Lebensqualität zum Teil erheblich beeinträchtigen. Eine dieser Schlafstörungen ist die Schlafapnoe, die vorrangig mit der sogenannten CPAP-Therapie (CPAP = Continuous Positive Airway Pressure) behandelt wird, indem dem Patienten während des Schlafes ein Luftstrom aus einem atemfähigen Gas über eine Nasalmaske kontinuierlich zugeführt wird. Die Maske ist über einen Schlauch mit einem Beatmungsgerät verbunden, das einen Lüfter umfaßt, der einen Gasstrom mit einem Überdruck von 5 bis 20 mbar erzeugt.A not inconsiderable number of people suffer from sleep disorders, which affect the daily well-being of these people and partially significantly impair their social and professional performance and their quality of life. One of these insomnia is the sleep apnea, which primarily concerned with the so-called CPAP (ositive CPAP = C ontinuous P A irway P ressure) is treated by the patient during sleep, an air flow from a breathable gas via a nasal mask is continuously supplied. The mask is connected via a hose to a ventilator that includes a fan that generates a gas flow with an excess pressure of 5 to 20 mbar.

Der Gasstrom wird dem Patienten entweder mit konstantem Druck zugeführt oder zur Erleichterung der Atemarbeit des Patienten beim Ausatmen auf ein niedrigeres Druckniveau abgesenkt. Obwohl Schlafapnoen nur kurzfristig auftreten und einen geringen Teil des Schlafes ausmachen, läuft der Lüfter bei beiden Verfahren während der gesamten Schlafdauer (Nacht), was die Akzeptanz dieser Schlafapnoe-Behandlung erschwert.The gas flow is either supplied to the patient at a constant pressure or is reduced to a lower pressure level to make it easier for the patient to exhale when exhaling. Although sleep apneas only occur for a short time and make up a small part of sleep, the fan runs during the entire sleep period (night) in both procedures, which makes acceptance of this sleep apnea treatment difficult.

Aufgabe der Erfindung ist es nun, die CPAP-Therapie patientenfreundlich zu gestalten.The object of the invention is now to make the CPAP therapy patient-friendly.

Diese Aufgabe wird mit einem Verfahren zur Steuerung eines Beatmungsgerätes dadurch gelöst, daß mit der Oszilloresistometrie (oszillatorische Resistenz-Messung = ORM) die oszillatorische Druckamplitude, die dem Atemwiderstand des Patienten entspricht, kontinuierlich gemessen wird, wobei nach dem Bestimmen des individuellen Atemwiderstandswertes (Basiswert der Druckamplitude) bei Abweichungen von diesem Wert dem Patienten Atemgas unter Druck zugeführt und die Gaszufuhr beendet wird, sobald der Basiswert wieder oder annähernd erreicht ist.This object is achieved with a method for controlling a ventilator in that the oscillatory pressure amplitude, which corresponds to the patient's breathing resistance, is continuously measured with oscilloresistometry (oscillatory resistance measurement = ORM), after determining the individual breathing resistance value (base value of the Pressure amplitude) in the event of deviations from this value, the patient is supplied with breathing gas under pressure and the gas supply is stopped, as soon as the base value is reached again or approximately.

Bei dem erfindungsgemäßen Verfahren zur Steuerung und Regelung eines Beatmungsgerätes zur Therapie von Schlafapnoe-Patienten wird dieses Gerät nur dann aktiviert, d. h. es wird dem Patienten nur dann Atemgas zugeführt, wenn durch eine Apnoe die Atemtätigkeit des Patienten gestört ist oder sich der Atemwiderstand - und somit auch die gemessene oszillatorische Druckamplitude - durch eine entstehende Apnoe ändert. Eine Störung der Atemtätigkeit des Patienten ist von einer Veränderung des Atemwiderstandes des Patienten begleitet. Dieser Widerstand wird ohne das Befinden des Patienten zu beeinflussen, auf einfache Weise zuverlässig und reproduzierbar über die Veränderungen der oszillatorischen Druckamplitude bestimmt. Diese bildet die Steuergröße für das Ein- und Ausschalten des Therapiegerätes, so daß eine Unterversorgung des Patienten mit Sauerstoff nicht eintritt.In the method according to the invention for controlling and regulating a respirator for the therapy of sleep apnea patients, this device is only activated, ie. H. Breathing gas is only supplied to the patient if the breathing activity of the patient is disturbed by an apnea or if the breathing resistance - and thus also the measured oscillatory pressure amplitude - changes as a result of apnea. A disturbance in the patient's breathing activity is accompanied by a change in the patient's breathing resistance. This resistance is easily and reliably determined in a reproducible manner via the changes in the oscillatory pressure amplitude without affecting the patient's condition. This forms the control variable for switching the therapy device on and off, so that the patient is not under-supplied with oxygen.

Das Befinden des Patienten kann bei einer vorteilhaften Weiterbildung des erfindungsgemäßen Verfahrens noch dadurch gesteigert werden, daß dem Patienten ständig Atemgas mit einem mäßigen Grunddruck von 3 bis 5 mbar zugeführt, der Gasdruck bei Abweichungen vom individuellen Atemwiderstandswert (Basiswert) angehoben und auf den Grunddruck abgesenkt wird, sobald der Basiswert wieder annähernd erreicht ist. Diese kontinuierliche Gaszufuhr unterstützt nicht nur die Atemarbeit des Patienten wohltuend, sondern wirkt sich sogleich vorteilhaft auf die Ermittlung der zur Steuerung des Druckes des Atemgases erforderlichen Parameter aus.The patient's condition can be beneficial Further development of the method according to the invention can be further increased by continuously supplying the patient with breathing gas with a moderate basic pressure of 3 to 5 mbar, increasing the gas pressure in the event of deviations from the individual breathing resistance value (basic value) and lowering it to the basic pressure as soon as the basic value is approximately reached again . This continuous gas supply not only supports the breathing work of the patient, but also has an advantageous effect on the determination of the parameters required to control the pressure of the breathing gas.

Im Verlauf einer beginnenden Apnoe bewirken Verengungen oder Erweiterungen der Atemwege eines Patienten Änderungen im Phasenwinkel der oszillatorischen Druckamplitude und des Atemflusses im Vergleich zu den entsprechenden Basiswerten bei normalem oder ungestörtem Atemhub. Diesen unerwünschten Veränderungen kann mit weiteren zweckmäßigen Ausgestaltungen der Erfindung dadurch begegnet werden, daß als zusätzliche Steuer- und/oder Regelsignale für das Beatmungsgerät der Phasenwinkel der Druckamplitude und/oder der Atemfluß des Patienten herangezogen werden, um bei signifikanten Abweichungen von den jeweiligen - zu Beginn der Therapie ermittelten - individuellen Basiswerten den Druck des zugeführten Atemgases so zu erhöhen, bis die Basiswerte wieder oder annähernd erreicht sind.During the beginning of apnea, narrowing or widening of a patient's airways cause changes in the phase angle of the oscillatory pressure amplitude and the respiratory flow compared to the corresponding basic values with a normal or undisturbed breath. These undesirable changes can be countered with further expedient refinements of the invention in that the phase angle is used as additional control and / or regulating signals for the ventilator the pressure amplitude and / or the respiratory flow of the patient are used in order to increase the pressure of the supplied breathing gas in the event of significant deviations from the respective individual base values determined at the beginning of the therapy until the base values are reached again or approximately.

Ein Beatmungsgerät zur Durchführung des Verfahrens nach der Erfindung besteht aus einer mit einer Atemmaske verbundenen und zweckmäßigerweise als Lüfter ausgebildeten Druckgasquelle und ist durch eine Einrichtung zur kontinuierlichen Messung der oszillatorischen Druckamplitude eines Patienten nach dem ORM-Prinzip sowie eine Steuer-Regeleinrichtung gekennzeichnet, die auf den individuellen Basiswert der dem Atemwiderstandswert eines Patienten entsprechenden oszillatorischen Druckamplitude einstellbar ist und die Druckgasquelle so aktiviert, daß dem Patienten Atemgas zugeführt wird, wenn signifikante Abweichungen des Atemwiderstandes vom Basiswert auftreten.A respirator for carrying out the method according to the invention consists of a compressed gas source connected to a breathing mask and expediently designed as a fan and is characterized by a device for the continuous measurement of the oscillatory pressure amplitude of a patient according to the ORM principle and a control and regulating device which relate to the individual base value of the oscillatory pressure amplitude corresponding to the respiratory resistance value of a patient is adjustable and the compressed gas source is activated in such a way that respiratory gas is supplied to the patient if there are significant deviations of the respiratory resistance from the base value.

Bei einer zweckmäßigen Ausgestaltung kann das Beatmungsgerät als weitere Steuerelemente zum Aktivieren der Druckgasquelle noch eine Einrichtung zum Messen und Bestimmen des Phasenwinkels der Druckamplitude und/oder eine als Pneumotachographen oder Meßblende ausgebildete Einrichtung zum Bestimmen des Atemflusses des Patienten aufweisen.In an expedient embodiment, the respirator can also have, as further control elements for activating the compressed gas source, a device for measuring and determining the phase angle of the pressure amplitude and / or a device designed as a pneumotachograph or measuring orifice for determining the patient's respiratory flow.

Bei einer anderen Weiterbildung der Erfindung kann das Beatmungsgerät noch mit einem auf die Bedürfnisse des Patienten einstellbaren Druckregler für das Atemgas versehen sein, wodurch die Akzeptanz des Therapiegerätes gesteigert wird, da der Patient mit einem für ihn angenehmen konstanten Druck beatmet wird, wenn die oszillatorische Druckamplitude und/oder der Phasenwinkel der Druckamplitude und/oder der Atemfluß des Patienten dem (den) Basiswert(en) entspricht (entsprechen).In another development of the invention, the respirator can also be provided with a pressure regulator for the breathing gas that can be adjusted to the needs of the patient, which increases the acceptance of the therapy device, since the patient is ventilated with a constant pressure that is pleasant for him when the oscillatory pressure amplitude and / or the phase angle of the pressure amplitude and / or the respiratory flow of the patient corresponds to the basic value (s).

Ein Ausführungsbeispiel des erfindungsgemäßen Beatmungsgerätes wird noch an Hand der Zeichnung, in der es schematisch dargestellt ist, beschrieben.An embodiment of the ventilator according to the invention will be described with reference to the drawing, in which it is shown schematically.

Das Beatmungsgerät zur Therapie der Schlafapnoe weist eine auf der Nase eines Patienten anordenbare Atemmaske 1 auf, die über einen Atemschlauch 8 mit einer als Lüfter ausgebildeten Druckgasquelle 2 verbunden ist. In der Atemmaske 1 sind die Sensoren (nicht gezeigt) einer Einrichtung 3 zum kontinuierlichen Messen der oszillatorischen Druckamplitude nach dem ORM-Prinzip vorgesehen. Von einer Steuer-Regeleinrichtung 4, die mit der Einrichtung 3 verbunden und auf den individuellen Basiswert der dem Atemwiderstand des Patienten entsprechenden oszillatorischen Druckamplitude einstellbar ist, wird die Druckgasquelle 2 so aktiviert, daß dem Patienten Atemgas bei signifikanten Abweichungen der Druckamplitude vom Basiswert zugeführt wird. In den Atemschlauch 8 ist eine Meßblende 7 eingesetzt, die den Atemfluß erfaßt und die entsprechenden Daten über eine Meßeinrichtung 6 an die Steuer-Regeleinrichtung 4 zur weiteren Beeinflussung der Druckgasquelle 2 weiterleitet. In der Atemmaske 1 sind außerdem noch die Sensoren (nicht dargestellt) einer anderen Einrichtung 5 zum Messen des Phasenwinkels der Druckamplitude vorgesehen. Die Einrichtung 5 sendet an die Steuer-Regeleinrichtung 4 Signale, die als zusätzliche Regelparameter bei der Aktivierung der Druckquelle 2 dienen.The respirator for therapy of sleep apnea has a breathing mask 1 which can be arranged on the nose of a patient and which is connected via a breathing tube 8 to a compressed gas source 2 designed as a fan. The sensors (not shown) of a device 3 for continuously measuring the oscillatory pressure amplitude according to the ORM principle are provided in the breathing mask 1. The pressure gas source 2 is activated by a control-regulating device 4, which is connected to the device 3 and can be adjusted to the individual base value of the oscillatory pressure amplitude corresponding to the breathing resistance of the patient, so that breathing gas is supplied to the patient in the event of significant deviations in the pressure amplitude from the base value. A measuring orifice 7 is inserted into the breathing tube 8, which detects the respiratory flow and forwards the corresponding data via a measuring device 6 to the control and regulating device 4 for further influencing the compressed gas source 2. In the breathing mask 1, the sensors (not shown) of another device 5 for measuring the phase angle of the pressure amplitude are also provided. The device 5 sends to the control and regulating device 4 signals that serve as additional control parameters when activating pressure source 2.

Claims (10)

Verfahren zur Steuerung eines Beatmungsgerätes zur Therapie der Schlafapnoe, dadurch gekennzeichnet, daß mit der Osziloresitometrie (oszillatorische Resistenz-Messung = ORM) die oszillatorische Druckamplitude eines Patienten, die dem Atemwiderstand des Patienten entspricht, kontinuierlich gemessen wird, wobei nach dem Bestimmen des individuellen Atemwiderstandswertes (Basiswert) der Druckamplitude bei Abweichungen von diesem Wert dem Patienten Atemgas unter Druck zugeführt und die Gaszufuhr beendet oder minimiert wird, sobald der Basiswert wieder oder annähernd erreicht ist.Method for controlling a ventilator for the therapy of sleep apnea, characterized in that the oscillatory pressure amplitude of a patient, which corresponds to the patient's breathing resistance, is continuously measured with oscillosititometry (oscillatory resistance measurement = ORM), after determining the individual breathing resistance value ( Base value) of the pressure amplitude in the event of deviations from this value, the patient is supplied with breathing gas under pressure and the gas supply is stopped or minimized as soon as the base value is reached again or approximately. Verfahren nach Anspruch 1, dadurch gekennzeichnet, daß dem Patienten ständig Atemgas mit einem Grunddruck von etwa 3 bis 5 mbar zugeführt, der Gasdruck bei Abweichungen vom individuellen Atemwiderstandswert (Basiswert) angehoben und auf den Grunddruck abgesenkt wird, sobald der Basiswert wieder oder annähernd erreicht ist.A method according to claim 1, characterized in that the patient is constantly supplied with breathing gas with a basic pressure of about 3 to 5 mbar, the gas pressure is raised in the event of deviations from the individual breathing resistance value (basic value) and reduced to the basic pressure as soon as the basic value is reached again or approximately . Verfahren nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß der Phasenwinkel der Druckamplitude des Patienten kontinuierlich gemessen und bei signifikanten Abweichungen vom - zu Beginn der Therapie ermittelten - individuellen Basiswert der Druck des Atemgases so erhöht wird, bis der Basiswert wieder oder annähernd erreicht ist.Method according to Claim 1 or 2, characterized in that the phase angle of the pressure amplitude of the patient is measured continuously and, in the event of significant deviations from the individual base value determined at the beginning of the therapy, the pressure of the breathing gas is increased until the base value is reached again or approximately. Verfahren nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der Atemfluß des Patienten gemessen und bei signifikanten Abweichungen vom - zu Beginn der Therapie ermittelten - individuellen Basiswert der Druck des Atemgases so erhöht wird, bis der Basiswert wieder oder annähernd erreicht ist.Method according to one of the preceding claims, characterized in that the respiratory flow of the patient is measured and, in the event of significant deviations from the individual base value determined at the beginning of the therapy, the pressure of the respiratory gas is increased until the base value is reached again or approximately. Beatmungsgerät zur Durchführung des Verfahrens nach Anspruch 1 oder 2, bestehend aus einer mit einer Atemmaske verbundenen Druckgasquelle und gekennzeichnet durch eine Einrichtung (3) zur kontinuierlichen Messung der dem Atemwiderstand eines Patienten entsprechenden oszillatorischen Druckamplitude nach dem ORM-Prinzip sowie durch eine Steuer-Regeleinrichtung (4), die auf den individuellen Atemwiderstandswert (Basiswert der Druckamplitude) des Patienten einstellbar ist und die Druckgasquelle (2) so aktiviert bzw. steuert, daß dem Patienten bei signifikanten Abweichungen des Atemwiderstandes vom Basiswert Atemgas mit erhöhtem Druck zugeführt wird.Ventilator for carrying out the method according to claim 1 or 2, consisting of a compressed gas source connected to a breathing mask and characterized by a device (3) for continuously measuring the oscillatory pressure amplitude corresponding to the breathing resistance of a patient the ORM principle and a control device (4) which can be adjusted to the patient's individual breathing resistance value (base value of the pressure amplitude) and which activates or controls the compressed gas source (2) in such a way that the patient receives significant deviations in breathing resistance from the base value Breathing gas is supplied with increased pressure. Beatmungsgerät nach Anspruch 5, dadurch gekennzeichnet, daß die Druckgasquelle (2) ein Lüfter ist.Ventilator according to claim 5, characterized in that the compressed gas source (2) is a fan. Beatmungsgerät nach Anspruch 5 oder 6, gekennzeichnet durch einen auf die Bedürfnisse des Patienten einstellbaren Druckregler für das Atemgas.Ventilator according to claim 5 or 6, characterized by a pressure regulator for the breathing gas which can be adjusted to the needs of the patient. Beatmungsgerät nach einem der vorhergehenden Ansprüche 5 bis 7, gekennzeichnet durch eine Einrichtung (5) zur kontinuierlichen Messung und Bestimmung des Phasenwinkels der Druckamplitude, welche Einrichtung (5) mit der Steuer-Regeleinrichtung (4) verbunden ist, die auf den individuellen Basiswert des Phasenwinkels des Patienten einstellbare Elemente aufweist.Ventilator according to one of the preceding claims 5 to 7, characterized by a device (5) for continuously measuring and determining the phase angle of the pressure amplitude, which device (5) is connected to the control-regulating device (4), which is based on the individual base value of the Phase angle of the patient has adjustable elements. Beatmungsgerät nach einem der Ansprüche 5 bis 8, gekennzeichnet durch eine mit einer Meßblende (7) oder einem Pneumotachographen in der Gaszuführleitung (8) verbundene Meßeinrichtung (6) zur kontinuierlichen Messung und Bestimmung des Atemflusses des Patienten, welche Meßeinrichtung (6) mit der Steuer-Regeleinrichtung (4) verbunden ist, die auf den individuellen Basiswert des Atemflusses des Patienten einstellbare Elemente aufweist.Ventilator according to one of claims 5 to 8, characterized by a measuring device (6) connected to a measuring orifice (7) or a pneumotachograph in the gas supply line (8) for the continuous measurement and determination of the patient's respiratory flow, which measuring device (6) with the control -Control device (4) is connected, which has elements adjustable to the individual base value of the patient's respiratory flow. Beatmungsgerät nach Anspruch 8 und 9, dadurch gekennzeichnet, daß in der Eirnichtung (5) aus Signalen von der Einrichtung (3) und der Meßblende (7) oder dem Pneumotachographen der Phasenwinkel der Druckamplitude bestimmt wird.Ventilator according to claims 8 and 9, characterized in that the phase angle of the pressure amplitude is determined in the single device (5) from signals from the device (3) and the measuring orifice (7) or the pneumotachograph.
EP95113816A 1994-09-08 1995-09-02 Ventilation apparatus for the treatment of sleep apnoea Expired - Lifetime EP0705615B1 (en)

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DE9414568 1994-09-08

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US6526974B1 (en) 1995-09-18 2003-03-04 John William Ernest Brydon Pressure control in CPAP treatment or assisted respiration
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WO2005068004A1 (en) 2004-01-20 2005-07-28 Hoffrichter Gmbh Respiration device for the treatment of sleep apnea and method for control thereof
CN1867370B (en) * 2004-01-20 2010-06-30 霍弗里希特有限公司 Respiration device for the treatment of sleep apnea
DE102007011924A1 (en) * 2006-03-08 2007-12-27 Weinmann Geräte für Medizin GmbH & Co. KG Method and device for controlling a ventilator
DE102007006689B4 (en) 2006-03-31 2021-07-29 Löwenstein Medical Technology S.A. Device and method for detecting obstruction during apnea phases by means of an additional pressure level
US8167812B2 (en) 2006-08-24 2012-05-01 Weinmann Gerate Fur Medizin Gmbh & Co. Kg Device and method for detecting obstructive events
CN107106800A (en) * 2014-10-27 2017-08-29 瑞思迈有限公司 The method and apparatus for treating hyperarousal illness
US10850054B2 (en) 2014-10-27 2020-12-01 ResMed Pty Ltd Method and apparatus for treating hyperarousal disorders
DE202017003149U1 (en) 2016-06-16 2017-08-02 Löwenstein Medical Technology S.A. Ventilator for APAP respiration with oscillatory pressure
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DE102017005629A1 (en) 2016-06-16 2017-12-21 Löwenstein Medical Technology S.A. Ventilator for APAP ventilation

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NO953455L (en) 1996-03-11
FI954092A (en) 1996-03-09
DE59510734D1 (en) 2003-08-07
CA2157815A1 (en) 1996-03-09
US5617846A (en) 1997-04-08
FI954092A0 (en) 1995-08-31
NO953455D0 (en) 1995-09-04
EP1306099A2 (en) 2003-05-02
NO311871B1 (en) 2002-02-11
ATE244033T1 (en) 2003-07-15
EP0705615B1 (en) 2003-07-02
ES2202334T3 (en) 2004-04-01
DK0705615T3 (en) 2003-10-20
EP1306099A3 (en) 2003-08-13

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